India Journal: No Country for Women

The story of sex selection is a national one, cutting across urban and rural India, and income and education levels.

In the two months since the provisional Census results showed a continuing decline in India’s child sex ratio, suggesting that up to half a million girls are being killed before birth each year, alarm and despair have been expressed in equal proportion by national and international observers. Inevitably, the conversation has moved from expressions of hopelessness about the problem to calls for greater intervention and activism from the government.

And, right on cue, the government machinery has responded, with the press reporting a meeting of ministries at the Prime Minister’s Office in late May to “deal with the problem on a war footing,” including the consideration of “urgent strategies” like tightened abortion rules. This is a mistake. While India faces a demographic and social challenge of consequence, policy makers and activists must stop imagining that there is an easy solution built on subversion of choices through new controls or new laws. Not only will they fail to fix the problem of sex selection but they run the risk of distracting the country from what can be a more effective long-term agenda: an agenda that does not merit the erosion of hard-earned progress in reproductive rights for women.

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India’s 2011 Census revealed that the child sex ratio (number of girls to boys 0-6 years of age) in the country fell, like it has in every decade since 1961. From 976 girls for every 1,000 boys in 1961, the ratio fell to 927 by 2001 and to 914 in the latest survey of 2011. These numbers are way off the country’s targets articulated in the 11th Five Year Plan: 935 by 2011-12 and 950 by 2016-17. In a normal population without artificial distortions, the ratio should be closer to 950. Clearly, Indian parents are translating their preference for a boy to active choices about the sex of their babies.

The story of sex selection is a national one, cutting across urban and rural India, and income and education levels. Between 2001 and 2011, the child sex ratio declined in 27 states and union territories. The states that showed substantial improvement, including Punjab, Haryana, Himachal Pradesh and Gujarat, have abysmally distorted sex ratios anyway, ranging from 830 to 890, where progress is only relative to the lows chalked up in 2001.If anything, what was predominantly a northwest India phenomenon has now caught the morbid imagination of other regions, too. Kerala, Chhattisgarh and the Northeast states stand as anomalies that have bypassed this expanding social regression.

India is not alone in the developing world in facing a demographic crisis of skewed sex ratios. China’s child sex ratio is around 840 and has been declining since the 1980s. Both South Korea and Taiwan faced similar challenges at an equivalent stage in their economic development. But while much of the attention is on the immediate problem of the missing girls, the real challenge in all these societies is a strong son preference that, not surprisingly, results in daughter discrimination, and more broadly, discrimination against women.

In many ways, son preference is the starkest indictment on the status of women in the country. When parents make the choice to abort their unborn daughters, it is the crudest expression of a society’s shared belief that women are neither equal to men nor will they experience the same opportunities. The reasons for the son preference can be traced to social norms that are deeply entrenched within what the International Center for Research on Women calls “gender-unequal, patriarchal” societies: societies that have “strong economic and social incentives to raise sons and eliminate daughters.”

The incentives are obvious: the extension of lineage has been through men; women leave the houses where they are born and nurtured to be absorbed into the husband’s family which gets the benefits of their economic productivity and fertility, usually preceded by hefty dowry payments; inheritance rights were usually solely for men; sons are seen to defend or exercise the family’s power while daughters supposedly have to be defended and protected; men are seen as the providers of old-age support for parents. And in an era of declining fertility, there is an even greater tendency on the part of parents to try to drive an “ideal” family size and composition.

The consequences of such a significant demographic distortion are well understood. Rather than scarcity leading to enhancement in the status of women, the more likely result is one of women facing increased danger in their daily lives. Many studies have pointed out that single men are more likely to be prone to crime in a social context, especially when the poorest of them are the least likely to find partners. A Chinese think-tank pointed to a possible government strategy of co-opting poor, unmarried men into the People’s Liberation Army with the only objective being absorption of a growing surfeit of young men in the country. In India, examples are starting to emerge depicting a new pattern of social displacement with brides being imported from the southern states to states with skewed sex ratios in conditions where marriage may just be an excuse for sexual exploitation by single men in the community.

If sex selection is the worst reflection of a society’s cultural norms and its consequences are debilitating for the community at large, then is the government not justified in looking for urgent strategies? Not if these strategies are predominantly focused on the belief that boy preference can be legislated away, that choices can be subverted post conception, and that quick short-term fixes exist to a deeply entrenched social mindset.

In the wake of the most recent numbers, the government is considering new measures including stricter enforcement of the Pre-Conception and Pre-Natal Diagnostic Techniques (Prohibition of Sex Selection ) Act, mandatory counseling for those who seek abortion, and registration of pregnancies. While all of these will help policy makers to be comfortable in the knowledge that they are doing something, and are seen to be doing something, none of these measures will really change the situation on the ground.

PCPNDT, first passed in 1993 and amended in 2003, prohibits determination or disclosure of the sex of the fetus, mandates registration and limits the use of ultrasound machines. Yet, in the nearly two decades since its introduction, the Act has not changed the reality on the ground much, and for valid reasons. Relying on a punitive law to modify entrenched social behavior may yield positive results, but not sufficiently positive to reverse the trends or eliminate discriminatory practices. With ultrasound machines being a necessary medical tool in prenatal care, and rapid technological advancements enabling easy identification of the sex of the fetus, it is unlikely that the enforcement ability of the state will ever catch up with technology or the convenient alliance between parents and practitioners.

Even worse, many of the measures being considered fundamentally undermine reproductive rights and a woman’s freedom to make her own choices, including accessing safe abortion services. Putting further limitations will not reduce the incidence of abortions, it will push abortions even further underground, placing the health of women even more at risk and at the mercy of quacks and poorly trained practitioners. This in a country where almost 20,000 women already die from unsafe abortions each year.

And, as always, it will be the poorest communities that will be hit the hardest. Similarly, mandatory counseling and the registration of pregnancies swipe at the heart of privacy, the single most valued attribute for women considering abortion across urban and rural India. In considering these two measures, there is an implicit assumption that it is the rural women and the urban poor in slums who need to be counseled into doing the right thing. As in many public health solutions, somehow there seems to be an onus on poor residents in villages to reveal private information about their lives and their health to a degree that would be unimaginable in high income, urban settings. And yet sex selection is as much of a high income, urban phenomenon as it is a rural poor issue.

Focusing on these reactive measures is a dissipation of scarce public resources and attention anyway, and does not address the underlying issue of boy preference and gender discrimination. So long as gender discrimination exists, parents will continue to have, and exercise, boy preference in one way or another.

Shifting attitudes and cultural norms on boy preference will take years, if not decades, but the elements of an effective framework (including legislation) are already in place. Punitive legislation like the PCPNDT Act that regulates discriminatory behavior is a part of this. Some of the improvements in Punjab and Haryana over the last decade have come on the back of tighter enforcement of controls and the registration of clinics. But, even more important is more effective implementation of several other laws and policies that are not punitive in nature but try to address the causes of gender discrimination, and an emerging framework of economic incentives that attempt to change the value of a girl child to her family and society.

In many ways, India has already embarked on such a program. The Hindu Succession Act of 2005 legislates that daughters can be inheritors of ancestral or joint family property. The Maintenance and Welfare of Parents and Senior Citizens Act makes it a legal obligation for heirs to provide maintenance support to parents, attempting to influence discrimination that is rooted in the belief that sons will provide for parents in their old age. Laws against dowry, gender-based violence and child-marriage have been in place for decades. Complementing these are new, experimental programs that attempt to increase the value of the girl child through cash transfers that are conditional on the provision of educational opportunities and health services to the girl. The impact of these programs will not be truly known for years but they do represent a possible approach to addressing rational reasons behind attitudes on gender.

Research from ICRW also shows that while wealth and economic development do not reduce the preference for sons, women’s education does make a difference. Educated women are less likely to prefer sons over daughters, and highly educated women are even less likely to do so. What becomes apparent, therefore, is that India’s immediate national priorities in education and health are also the right priorities when it comes to addressing gender attitudes and discrimination over the long term.

South Korea, one of the few countries to reverse a decline in the child sex ratio, is evidence that a non-punitive approach will yield results. From a distorted sex ratio in the 1980s driven by similar social attitudes and gender preferences as those in India, South Korea registered normal ratios by 2007. What the country did successfully was to address the economic and social incentives that had fostered boy preference. This included changes in inheritance laws that were male-centric and creating an old-age pension system that reduced income dependence on children. Supporting these policies were broader changes in society that saw an increase in the participation of women in the workforce and a growing recognition that, in many ways, daughters remain more emotionally connected to their parents in their old age than sons.

The government’s renewed focus on the agenda of sex selection is absolutely legitimate and necessary. In many ways, the issue brings together some of the toughest social and economic challenges that the country faces into a heart-wrenching headline. But, precisely because deeply entrenched social norms and attitudes are involved, there is also no easy solution available through writs and controls. The only way is to persist with policies that attempt to shape norms for the long term that stand a chance of creating a country with women as equals. And, in the meantime, there is no alternative but to start planning for the certain consequences that await the country, from the demographic distortions created by the choices of millions of parents to exercise their preference for boys.

Ajit Mohan has worked on a range of public policy issues such as urban renewal, education and health. He co-authored the McKinsey Global Institute’s “India’s Urban Awakening” report, published in 2010, and has advised the International Center for Research on Women, which works on leveraging women to reduce poverty. Priya Nanda is Asia group director for development for ICRW, a role that involves overseeing research and policy work on issues related to gender equality and reproductive health and rights.

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